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<br />II~-=, <br /> <br /> <br />State. Tax Lien <br />Statement of Termination or <br />Certlflcata of Partial Release or Subordination <br /> <br />SocIal Security Numl:l., or <br />Fed.,"II,D,Numtu,r <br /> <br />r <br /> <br />'88- 106931 <br /> <br />TAXPAYER NAME AND MAILING ADDRESS <br /> <br />BUllnllu Nama <br /> <br />Nama <br /> <br />St....t Addren <br /> <br />Strut or Othn MIlIlng AddreSl <br /> <br />ln11 F.at- Rofa"'II",lr- <br />City <br /> <br />Stata <br /> <br />Zip Cada City <br /> <br />Stlte <br /> <br />Zip Code <br /> <br />GrAnd Inl And HE 68801 I Fremont HE 68025 <br /> <br />Pursuant to the revenue lawB of the State of Nebmllka, notice is hereby given that the State Tax Lien which has been duly <br />med by tbe Nebraska Department of Revenuell/lllin.t the above named taxpayer, ia terminated, partlaBy releued, or subordi- <br />nated to the extent indicated below. <br /> <br />I TYPE OF ACTION <br />IXI TERMINATION OF TAX LIEN. The State Tax Lien is hereby fully terminated. <br /> <br />o PARTIAL RELEASE. The State Tax Lien is partially released as follows. <br /> <br />Name of party makIng ,equest and rllsponslble for filing clIlrtlflcate of parllal release with appropriate flllng ofnCl!lr. <br /> <br />o SUBORDINATION. The State Tax Lien is subordinated as follows. <br /> <br />Name of party makIng request and responllble for filing certJllcate 01 subordination w\1h appropriate filing officer. <br /> <br />I hereby certify that the Nebraska Dapartment of Revenue has complied with the revenue laws of the State of NebriUka In the <br />determination oU11e tarmln.tlon, partial release or subordination Indicated above. <br />,,;,~ . <br />~~?(j <br /> <br />Rpvpnnp Agpn' /'" /. ",./y F <br />Title _ oate7c-" <br />{;). ...--... A--::;bs..,.. ....;- ~ ,'- Iii. /A.I/8'r <br />Title ~ . Date <br />---1 <br /> <br /> <br />FOR COUNTY OFFICIAl: S USE <br /> <br />(, <br /> <br />'. <br />'C: <br /> <br />t"': <br /> <br />. NEBRASKA DEPARTMENT OF REVENUE - White and CanarV Copies <br /> <br />TAXPAYER - Pink CoPV <br /> <br />COUNTY OFFICE - Goldenrod COpy <br />4-232-68 Rev. 5.86 <br />Supersedel 4-232.68 Rey. 1.81 <br /> <br />4r~" <br /> <br />u <br />